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<table border="0" class="report_table" width="100%" cellpadding="0" cellspacing="0" bordercolor="#000000">
  <tr>
    <td width="3%" rowspan="2" class="data" ><div align="center"><strong>STT</strong></div></td>
    <td width="20%" rowspan="2" class="data"><div align="center"><strong>H&#7885; v&agrave; t&ecirc;n (c&aacute; nh&acirc;n,&nbsp; &#273;&#7841;i di&#7879;n t&#7893; ch&#7913;c)</strong></div></td>
    <td width="7%" rowspan="2" class="data"><div align="center"><strong>&#272;&#7889;i t&#432;&#7907;ng</strong></div></td>
    <td width="20%" rowspan="2" class="data"><div align="center"><strong>H&#7897; kh&#7849;u th&#432;&#7901;ng tr&#250;</strong></div></td>
    <td width="8%" rowspan="2" class="data" ><div align="center"><strong>S&#7889; gi&#7845;y ch&#7913;ng nh&#7853;n</strong></div></td>
    <td width="7%" rowspan="2" class="data" ><div align="center"><strong>Ng&#224;y c&#7845;p</strong></div></td>
    <td colspan="3" class="data" WIDTH="193"><div align="center"><strong>&#272;</strong><strong>&#7883;a ch&#7881; l&ocirc; &#273;&#7845;t </strong></div></td>
    <td class="data" ROWSPAN="2" WIDTH="8%" ><div align="center"><strong>Ghi ch&#250;</strong></div></td>
  </tr>
  <tr>
    <td width="5%" class="data"><div align="center"><strong>Th&#7917;a s&#7889;</strong></div></td>
    <td width="5%" class="data" ><div align="center"><strong>T&#7901; b&#7843;n &#273;&#7891; s&#7889; </strong></div></td>
    <td width="17%" class="data" ><div align="center"><strong>&#272;&#7883;a ch&#7881; </strong></div></td>
  </tr>
  <tr align="center">
  	<td class="data">(1)</td>
  	<td class="data">(2)</td>
  	<td class="data">(3)</td>
  	<td class="data">(4)</td>
  	<td class="data">(5)</td>
  	<td class="data">(6)</td>
  	<td class="data">(7)</td>
  	<td class="data">(8)</td>
  	<td class="data">(10)</td>
  	<td class="data">(11)</td>
  </tr>
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